Transition from the intra-uterine environment to extra-uterine life is a dynamic, yet stressful, event for the fetus. Similarly, the critical physiological, neuro-behavioral and regulatory changes which must occur immediately after birth also result in significant neonatal stress. The multiple changes during this sensitive period necessitate significant neonatal adaptations during a very short time-period. Evidence documented in recent scientific reports and research studies, however, suggests that the neonate, or newborn, needs “only the mother” to make an optimal transition during this highly stressful and sensitive period. In fact, skin-to-skin-contact (SSC) between the mother and infant during the immediate post-delivery period mitigates stress associated with the birthing process, facilitates neonatal autonomic, regulatory, motor, and interactive adaptation, and eases overall fetal transition to extra-uterine life. Moreover, evidence suggests that both short-term and long-term benefits result from adoption of this “natural” practice.
Multiple benefits of adopting SSC during the immediate post-delivery period have been documented in the literature:                1. SSC mediates the neonatal stress response and promotes physiological regulation and stabilization:                    a. Facilitates neonatal thermo-regulation;            b. Facilitates neonatal cardio-pulmonary stability;            c. Increases neonatal sleep organization;            d. Promotes earlier glucose regulation;            e. Facilitates greater relaxation and reduces crying; and            f. Promotes analgesia during invasive procedures.                        2. SSC is associated with early initiation and longer duration of breastfeeding:                    Breast milk is the optimal source of nutrition and source of natural immunity for the infant. Currently-accepted evidence-based recommendations regarding breastfeeding indicate that this practice should be initiated within 30-60 minutes after delivery (American Association of Pediatrics, 2012; BFHI, 2009). Immediate mother-infant SSC after delivery has been associated with the following benefits:            a. Increased ability of the neonate to recognize the mother's milk;            b. A higher rate of successful initiation of breastfeeding;            c. A longer duration of breastfeeding; and            d. Higher prevalence of timely neonatal metabolic/glucose regulation;                        3. SSC is associated with positive infant developmental and social benefits:                    a. Increased maternal-infant interaction; maternal affection, facilitates bonding;            b. Greater tactile and verbal stimulation of the infant by the mother;            c. Vocal parental-infant interaction after birth; and            d. Greater prevalence of future mother-infant attachment.                        4. Multiple maternal benefits have also been documented:                    a. Release of oxytocin which facilitates control of bleeding in immediate post-partum period;            b. Increased reported maternal satisfaction and positive feelings;            c. Increased reported maternal feelings of relaxation and well-being;            d. Decreased reported maternal anxiety and stress;            e. Higher reported breastfeeding self-efficacy and overall confidence with breastfeeding;            f. Increased reported maternal sensitivity to the infant; increased maternal affection and attachment; and            g. Fewer reported post-partum depressive symptoms.                        
The rate of Cesarean delivery has risen markedly in the near past. In fact, according to the most recent statistics from the U.S. Center for Disease Control and Prevention (CDC, 2014), the current Cesarean delivery rate in the U.S. has risen to 32.8% of all deliveries. Furthermore, in spite of the compelling evidence in support of initiating SSC between the mother and infant immediately after birth, the adoption of this practice is limited to the period after Cesarean delivery, not during delivery. Thus, a significant number of mother-infant dyads are denied the opportunity for a widely-accepted standard of care that facilitates both short-term and long-term physiological, psychological, social and developmental adaptation of the baby and mother.
Because of the different routines required in the operating room due the highly controlled environment for the surgical procedure, the lower room temperature in the operating suite, the close surveillance of the mother required by the anesthesiologist during the operative procedure, and the sterile operative field environment, many misperceptions, fears and lack of understanding among healthcare providers commonly exist regarding the standard of care for SSC. These misperceptions and fears create many challenges to the adoption of SSC. Thus, it is common practice in the operating suite for the neonate to be placed under a radiant warmer and swaddled or transported directly to the nursery. All of these options result in the delay of immediate bonding between mother and her neonate.
One significant barrier to SSC immediately after birth in the operating suite is the physical barrier between the mother and her newly delivered baby created by the sterile field. The sterile field must be maintained throughout the Cesarean procedure, which includes, in addition to the delivery, the post-delivery wound closing and dressing. The present state of art in the field of fenestration drapes lacks an effective means to bridge the sterile field to access the mother's skin immediately upon delivery without, at the same time, compromising the sterile barrier.